High cholesterol? causes and risk of high cholesterol.
High cholesterol? Causes and risk. How can you reduce your risk of high cholesterol? – Dr. Aniqa Jahin
Cholesterol is a steroid (derived lipid) that is produced by the liver as lipoproteins. It’s an essential structural component of cell membranes & plasma lipoproteins. It’s also known as a major constituent of gall stones & the chief pathogenic factor in the pathogenesis of atherosclerosis. Lipoproteins carry cholesterol & triglycerides through blood. To lead a healthier lif you need to be aware of the causes and risk of high cholesterol. As cholesterol doesn’t dissolve in water it’s unable to transport in blood on its own. There’s mainly two types of cholesterol:
- LDL (low-density lipoprotein)
- HDL (High-density lipoprotein)
LDL is known as bad cholesterol. If your blood contains too much LDL cholesterol carried by low-density lipoprotein, is considered as high cholesterol. This can further lead to coronary diseases like heart attack, stroke & many other health issues which have become a common problem nowadays. If it’s left untreated, it can be deadly too. Cholesterol level varies according to ages, gender, etc. As there are no specific symptoms of it you might have high cholesterol & totally unconscious about it. So it’s important to checkup your cholesterol level at least once a year to avoid further physical injuries.
Her in this article I am going to discuss causes and risk of high cholesterol and the ways how you can reduce your risk of high cholesterol. After reading this if you have any questions to ask please feel free to comment here or email us at [email protected]
What is cholesterol?
Cholesterol is a kind of lipid. It’s insoluble in water & soluble in non-polar solvents such as ether, chloroform, benzene, etc. The total cholesterol content in 70 kg adults is 140 gm (2gm/kg). The free or excess cholesterol is removed from the tissue by plasma high-density lipoprotein(HDL) and transported to the liver. Or it’s distributed to cell membranes & cytoplasm, body fluids(except CSF), bile, brain & suprarenal glands, blood, different tissues & muscles. As HDL helps in the excretion & distribution of the excess cholesterol from the body it’s known as good cholesterol. Another type of cholesterol called LDL (High-Density lipoprotein) which increases the excess cholesterol is our body & prevents excretion is known as bad cholesterol & this situation is known as high cholesterol.
In the usual diet, small quantities of cholesterol are present. Cholesterol is also known as a sterol compound that contains not fatty acid but it does exhibit some of the physical & chemical characteristics of fats. In addition, it’s derived from fats and metabolized similarly to fat. After metabolism they release energy. But a greater quantity can be harmful to your body.
What is High cholesterol?
If your total cholesterol level is high because of a high LDL level, can be defined as “High Cholesterol”. Normal serum cholesterol level is-
- Total cholesterol: 8-8.3 mmol/L
- Free cholesterol: 7-2.7 mmol/L
If there’s an increase in total cholesterol than normal values because of a high HDL level it might not be a fact. But if it occurs because of a high LDL level is known as high cholesterol & you may be at higher risk of heart disease or stroke.
Difference between good cholesterol and bad cholesterol:
There are 2 different types of cholesterol. Among them, LDL ( low-density lipoprotein) is known as bad cholesterol as it builds up fatty substances throughout the blood vessels (e.g. arteries), makes them narrower by hard fat particles known as plaque & results in the irregularity of blood flow to the functional organs. Thus it can cause several diseases even lead to death.
On the other hand, High-density lipoprotein is a necessity of our body & It’s known as good cholesterol. It serves as a reservoir of apoproteins and transports cholesterol from the peripheral tissue to the liver for degradation and excretion.
Ideal cholesterol level:
Cholesterol level is measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The normal cholesterol level for most adults are given below:
- Total cholesterol: less than 200 mg/dL
- HDL: more than 40 – 60 mg/dL
- LDL: 70 – 130 mg/dL
- triglycerides: 10 – 150 mg/dL
An increase of HDL is better for our entire health & body’s mechanism. On the other hand, the lower the LDL/triglyceride is the better. An increase in LDL/triglyceride may lead to stroke, heart diseases, atherosclerosis, and so on.
Function & effects of triglycerides:
Triglyceride is also a kind of derived lipid. It’s a neutral fat which is a major constituent in food of animal origin but much less so in food of plant origin. Having too many triglycerides in your blood can increase your risk of heart disease. After you eat, the excess triglycerides are stored in your fat cells to be used for energy later. Whenever you eat more calories your body produces more triglycerides and store them in the cells and increases blood triglyceride levels. High triglycerides are as dangerous as high LDL when it comes to your risk for coronary diseases. To lower triglycerides, a low carb & low-fat diet is recommended.
causes and risk of high cholesterol :
- Unhealthy diet: Intake of food containing too much-saturated fat can be a reason behind the increase in your cholesterol level. Eating too many oily foods, butter, cream, whole milk & other dairy products, red meat, Bakery items with refined sugar, regular white bread, rich food, beverages, soft drinks are up on the list. But consuming in a minimum portion doesn’t affect that much.
- Drinking alcohol: It’s found in the research that, drinking too much alcohol can increase your LDL cholesterol and triglycerides. So, regular intake of alcohol can increase the risk of high cholesterol. It can be consumed in a little portion but better to avoid for your better self.
- Smoking: Smoking is one of the biggest reasons behind the increase in cholesterol & other deadly diseases as well. It’s prohibited at any cost for a healthy lifestyle. Cigarette smoking damages the walls of your blood vessels & may lower the secretion of HDL as well.
- unhealthy lifestyle: Workouts are very important to keep the body active throughout the day. Exercise helps boost your body’s HDL or good cholesterol. Leading a lazy lifestyle & not exercising enough can result in unnecessary body fat that can be a cause of the increase in cholesterol level.
- Age: As you age, your organs can not work as same they did before. As a result, their functions slow down. The liver mainly serves to remove the excess LDL from the body. At this stage, your liver becomes less able to remove LDL cholesterol & causes high cholesterol issues.
- High blood pressure: High blood pressure & high cholesterol are related to each other. The blood pressure increase as a result of blocked blood vessels by excessive cholesterol stored inside of it.
- Obesity/ overweight issues: Being overweight indicates that you are inactive & following an unhealthy lifestyle. If your overweight you may have an excessive amount of triglycerides in your body as well as bad cholesterol (LDL) is more present in your blood than good cholesterol (HDL) because of bad food habits. Secondly, it means that your body mass index (BMI) is also higher than normal. Because a high BMI can be an indicator of high body fatness. For most adults, the ideal BMI is in the 18.5 to 24.9 range. If your BMI is above the range you are overweight and may have high cholesterol issues. BMI over 30 or greater puts you at risk of high cholesterol.
- Diabetes: High blood sugar level can be a reason behind damaging the linings of blood vessels. On the other hand, high blood sugar can decrease HDL cholesterol and increase VLDL ( very low-density lipoprotein) which can be very risky.
But there are some high cholesterol conditions & factors that are passed down through families & can’t be controlled. Such as-a family history of high LDL, high cholesterol /triglycerides, particular medical conditions ( kidney or liver disease or hypothyroidism), etc. In this case, the only change in lifestyle & daily habits can’t be enough. You have to go through proper medication & regular checkups at least twice every 6 months.
Symptoms of high cholesterol :
Unfortunately, in most cases, there is no specific symptom to find out whether you have high cholesterol or not. People may have high cholesterol issues & do not even aware of it.
If you have a high level of LDL (high cholesterol) in your body, this excess cholesterol will be stored in your arteries. A long time of storage makes it harder (though cholesterol is a fatty substance) & it’s known as “ plaque “. As It’s built up inside the blood vessels the plaque makes the vessels narrower & sometimes blocks the artery. These blood vessels carry blood from your heart to the rest of your body. If they are blocked, the entire regulation of blood supply messes up. There’s a lack of blood supply in the vessels of different organs of the body.
Such as:- A blocked artery to the heart can cause a heart attack. At the same time, a blocked artery to your brain can cause a brain stroke.
Other symptoms/risk factors:
- Angina, severe chest pain
- Numbness or weakness in your extremity/shoulders
- Extreme tiredness or fatigue
- Back pain, discomfort /pain in jaw/neck
- Dizziness & feelings
- Breathing issues
- Chronic kidney failure
- Peripheral vascular diseases
- Bile imbalance
The earlier you will be able to identify the risk factors it will be better for future health. If you are regular in a routine checkup ( e.g. blood test), it’s possible to find out if you have a high cholesterol level before any life-threatening event happens. Most people don’t figure out they have high cholesterol until they suffer from deadly issues like coronary/ neural diseases. As a result, it creates a negative impact on your overall health.
Formation of cholesterol:
Cholesterol is a substance that is present in the normal diet. It can be absorbed slowly from the gastrointestinal tract into the intestinal lymph. It’s highly fat-soluble but slightly soluble in water & specifically capable of forming esters with fatty acids. About 70 percent of the cholesterol in the Lipoproteins of plasma is in the form of cholesterol esters. The cholesterol absorbed each day from the gastrointestinal tract is called exogenous cholesterol. An even quantity is formed in the cells of the body called endogenous cholesterol. Essentially, all the endogenous cholesterol that circulates in the Lipoproteins of plasma is formed by the liver, but all other cells of the body form at least some cholesterol which is consistent with the fact that many of the membranous structures of all cells are partially composed of this substance.
The total concentration of lipoproteins in the plasma averages about 700 milligrams per 100 milliliters of plasma (700 mg/dl). It is broken down into the following individual lipoprotein constituents:
- Cholesterol – 180 mg/dl of plasma
- Phospholipids – 160 mg/dl of plasma
- Triglycerides – 160 mg/dl of plasma
- Protein – 200 mg/dl of plasma
Almost all the Lipoproteins are formed in the liver which is also where most of the plasma cholesterol, Phospholipids & triglycerides are synthesized. In addition, a small quantity of HDL synthesized in the intestinal epithelium during the absorption of fatty acids from the intestine. The main function of lipoproteins is to transport their lipid components in blood for different purposes.
How LDL is stored in the cell?
Low-density lipoprotein or “LDL” specifically increases the level of cholesterol & results in high cholesterol. The plasma concentration of this LDL is increased by several factors. An important factor in causing atherosclerosis is a high plasma concentration of cholesterol in the form of LDL. Increased low-density lipoprotein is the main reason for high cholesterol levels that’s why it is defined as “ Bad Cholesterol”.
LDLs contain 20% of protein & 80% of lipid with a higher concentration of cholesterol, Phospholipid & cholesterol ester. LDL particles are produced in circulation from VLDL. It contains much less triacylglycerol than VLDL and has a high concentration of cholesterol & cholesterol esters. 70% of LDL returns to the liver and 30% moves to peripheral tissues. From 30% LDL of peripheral tissue, 1/3 is oxidized in circulation which is consumed by macrophages, becoming foam cells. Foam cells accumulate releasing growth factors & cytokines that stimulate the migration of smooth muscle cells from the media to the intima of blood vessels that produce collagen and form atherosclerotic plaques.
The primary function of LDL is to provide cholesterol to the tissues. LDL particles bind to the cell surface membrane LDL receptors that recognize apo B-100 and form LDL receptor complex which is internalized by endocytosis. LDL receptor complex fuses with other similar vesicles and from the endosome. Receptors separate and migrate to the cell surface. LDL particles are digested by lysosomal enzymes, releasing free cholesterol, fatty acids, amino acids, and Phospholipids. The free cholesterol is utilized by the cell. If cholesterol does not require immediately, it is esterified by the enzyme acyl cholesterol acyltransferase (ACAT) and stored in the cell. If there’s too much cholesterol (LDL) built up in the walls of blood vessels can block the arteries by creating plaques. Thus how high cholesterol or excessive LDL can further lead to heart attack, stroke & so on.
Factors that regulate plasma cholesterol concentration:
. Genetic factor: genetic predisposition is strongly associated with hypercholesterolemia.
. Sex: Males have higher plasma cholesterol than females.
. Age: plasma cholesterol increases with age.
- Cholesterol-rich food increase cholesterol concentration.
- Saturated fatty acid (e.g. animal fat) intake increase plasma cholesterol because decrease LDL catabolism & inhibit the conversion of cholesterol to bile acid excretion.
- Unsaturated fatty acids ( e.g. fish oil, vegetable oil) intake decreases plasma cholesterol because of the increased LDL catabolism & stimulates the conversion of cholesterol to bile acid excretion.
- Dietary fibers decrease plasma cholesterol concentration.
- Stress releases catecholamine which causes lipolysis to provide fatty acid to the liver. The liver utilizes fatty acids & increases plasma LDL to raise plasma cholesterol level.
- Regular meditation, physical exercises & workouts reduce plasma cholesterol.
- A sedentary lifestyle increases plasma cholesterol.
Sources of cholesterol:
Your body produces cholesterol by itself whenever it needs it. It’s also found in our everyday diet. According to sources, it can be divided into 2 types-
- Dietary sources/exogenous sources: Only from animal food; e.g. egg yolk, liver, brain, chicken, beef, mutton, prawn, etc.
- Endogenous synthesis: synthesized in the body by virtually all tissues mainly liver, intestine, adrenal cortex, and reproductive tissues including ovaries, testes, and placenta.
Lean meat, Egg whites, pastured steak, sardines, and low-fat yogurt are cholesterol-rich but so nutritious that you can add them to your diet to increase HDL.
Foods to avoid:
Unfortunately, intake of food that contains high saturated & trans fats such as processed packet/tin can foods, full-fat dairy products ( cheese, butter, full-fat yogurt), deep-fried fast foods & junk foods, foods made directly from animal fat, red meat, etc. are high in LDL and produces bad cholesterol in your body. But limited intake of high-cholesterol foods might be allowed depending on your doctor’s recommendation.
How to prevent high cholesterol:
There’s no way to control genetically influenced high cholesterol. You can lower the risk rate by changing your diet & maintaining a healthy lifestyle. Otherwise, it can be managed.
Measures are taken to reduce serum cholesterol:
- Calorie restriction
- Avoidance of animal fat & cholesterol-rich food
- Regular exercise
- Avoidance of stress & sedentary lifestyle
- Dietary fiber and fish intake
- Drugs to inhibit endogenous cholesterol synthesis
- Avoid smoking & excessive alcohol consumption.
- Maintaining a healthy weight
- get your cholesterol levels tested on a regular basis.
The earlier you will start making healthy lifestyle choices it’s easier to prevent high cholesterol as well as any other diseases, such as- heart attack, angina, stroke, etc. It’s recommended to check your cholesterol level every 4 to 6 years starting at the age of 20 as cholesterol level starts to rise after 20. Men are generally more prone to high cholesterol than women. So, a frequent checkup is needed for them. After menopause, the risk of high cholesterol increases in women. Patients dealing with diabetes should be monitored properly cause they are also at a higher risk.
How to control high cholesterol naturally:
Proper changes in your diet can reduce cholesterol and improve your entire health. Adding nutritious food to your diet can & eliminating excessive intake can help you to prevent and control your high cholesterol. Natural food ingredients that act as medicines & deal with high cholesterol issues are-
- Whole grains (oats, barley, etc.)
- Nuts & vegetables (almond, cashews, pistachio)
- Extra virgin olive oil, sunflower oil
- Soy/soy milk instead of saturated dairy products
- Fish with omega-3 fatty acid (tuna, trout, salmon)
- Beans, eggplant, okra, kale, avocado, Brussels sprouts, tomatoes
- Citrus fruits ( e.g. strawberries, apples, grapes)
- Soluble Fiber Supplements
- Green tea
- Legumes & cheek pea
- Dark chocolate
- Seeds ( chia seeds, flax seeds)
By following a proper diet you can improve your heart health and lower your cholesterol. If you’re overweight, losing 5-10% of your body weight may help lower your cholesterol.
Atherosclerosis, a major risk factor:
Atherosclerosis is such a disease of the large and intermediate-sized arteries in which fatty lesions called atheromatous plaques; develop on the inside surfaces of the arterial walls. Arteriosclerosis, in contrast, is a general term that refers to thickened and stiffened blood vessels of all sizes. One abnormality that can be measured very early in blood vessels that later become atherosclerotic is damage to the vascular endothelium. An important factor in causing atherosclerosis is the high plasma concentration of cholesterol in the form of LDLs. Calcium salts that participate with cholesterol and other lipids cause plaque, leading to bony-hard calcifications that can make the arteries rigid tubes and creates a sudden blockage of all blood flow in the artery. Where they protrude into the flowing blood, their rough surfaces ( if ruptured) can cause blood clots to develop & thus how the artery can get blocked as well.
Atherosclerosis can also develop because of hypertension cause it increases the risk of atherosclerotic coronary artery diseases. Likewise, a person with diabetes mellitus or overweight/ obese patients is also at risk of coronary diseases. If these risk factors occur together, it greatly increases the risk of atherosclerosis which in turn may lead to heart attack, stroke & kidney diseases.
Role of High-density lipoprotein in preventing high cholesterol:
Much less is known about the function of HDL compared with that of LDL. It’s believed that HDLs can actually absorb cholesterol crystals that are beginning to be deposited in arterial walls. Animal experiments also suggest that HDL may have other actions that protect against atherosclerosis as well as high cholesterol. Such as- inhibition of oxidative stress and Prevention of inflammation in blood vessels. Whether or not these mechanisms are true, Epidemiological studies indicate that when a person has a high ratio of High-density to low-density lipoproteins, the likelihood of developing atherosclerosis & high cholesterol is greatly reduced. Yet, clinical studies with drugs that increase HDL levels have failed to demonstrate decreased risk for cardiovascular diseases. These discrepant results indicate the need for additional research on the basic mechanisms by which HDL may influence high cholesterol.
How to measure high cholesterol (Cholesterol test):
A simple blood test is performed to check your cholesterol level. A complete cholesterol test is known as a lipid panel or lipid profile. A complete cholesterol test is done by measuring the total cholesterol level, LDL, HDL & triglyceride level in the blood. Before performing the test your doctor may ask you to fast and avoid eating or drinking anything other than water for nine to 12 hours before the test. If you are going through any health problems, medications and supplements you must share this with your doctor. Otherwise, the result can be wrong. Because some medications (e.g. birth control pill) may increase your cholesterol level as a side effect. Your family history of heart health is also an important fact to note.
The process takes only a few minutes and it’s totally painless. Your doctor will collect your blood sample & it’ll be moved to the lab for further diagnosis. Some people may feel faint & slight pain where the blood is drawn. If the tools are not sanitized properly there is a huge risk of infection. So, the patient should go through proper observation. Your glucose level & thyroid is also checked to figure out if they are active & working in a proper way.
Medications of high cholesterol:
Several types of drugs have proved to be valuable in preventing high cholesterol. If you are already suffering from high cholesterol, you have to take medication according to your doctors’ recommendation. There are few groups from which doctors suggest which one you should go with. Among them, statins are the most used medicine to treat high cholesterol. It increases the activity of the liver, slows down LDL production, and helps to remove LDL that is already in the blood. simvastatin (Zocor) and pravastatin (Pravachol) are mostly used because they have the least side effects so far. Besides, Bile acid sequestrants, Niacin, or nicotinic acid, Fibrates are also used in the treatment of high cholesterol. They individually increase HDL levels or lowers LDL/triglyceride. An injectable medicine called PCSK9 inhibitors is used for those who are suffering from familial hypercholesterolemia ( genetically influenced high cholesterol).
But there are several side effects of every medicine. Such as – most common side effect of statins is muscle pain. low blood platelet count, decrease energy, dizziness, kidney and liver problems, digestive system problems can be found in some cases. You must consult with your physician before taking any medication or supplements.
At last, it can be said that high cholesterol is totally manageable by making lifestyle changes and taking prescribed medications. Therefore appropriate preventive measures are valuable in decreasing heart attack. Studies show that for each 1 mg/dl decrease in LDL cholesterol in the plasma there is about a 2 percent decrease in mortality from atherosclerotic heart diseases. changes to your diet, proper workout & maintaining a healthy stress-free lifestyle can help you to prevent having high cholesterol in the first place.
Does water help cholesterol?
Almost 25% of cholesterol comes from the diet. Water helps in the digestion of food which is very important for maintaining an ideal cholesterol level. In fact, dehydration decrease blood volume, as a result, low blood pressure & blood flow which can lead to irregularities in cholesterol level.
What is the best home remedy for cholesterol?
Dietary change is the best home remedy for cholesterol. Foods containing vitamins, minerals & antioxidants are proved to lower high cholesterol. Such as green tea, garlic, turmeric, fish with Omega-3 fatty acid, fibers(fruits & vegetables).
Does garlic lower cholesterol?
Some research has shown that garlic can decrease total cholesterol, LDL & triglyceride levels. aged garlic extract can help reduce the amount of “soft plaque” in the arteries. It also helps to unclog your arteries & blood clot.
Is rice bad for cholesterol?
White rice used to increase your blood sugar very quickly. As a result, you might get hungry and lead to overweight. This extra fat gets stored in your body & also decreases the clearance of LDL cholesterol from your blood. And increases the chance of high cholesterol. It also may result in a higher risk of type 2 diabetes. Otherwise, brown rice has more fiber and antioxidants in it. It also contains a lot more important vitamins and minerals that are good for our health.
Is yogurt good for cholesterol?
Yogurt contains essential bacterial components which are considered to achieve healthy blood pressure and cholesterol levels. Yogurt can reduce LDL and triglycerides levels and lower the possibility of heart diseases. (e.g. Greek yogurt). It’s also very important for good metabolism.
Writer: Dr. Aniqa Jahin
BDS (Bachelor Of Dental Surgery)
Mymensingh Medical College
Edited By: Al-Rresalat
BA (hon’s) in English
Arrival Fashion Ltd.
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